Subclassification of small for gestational age children with persistent short stature: Growth patterns and response to GH treatment

Aim: We determined whether subclassification of short small for gestational age (SGA) children according to birth anthropometrics could delineate different patterns in gestation, delivery, postnatal growth, response to growth hormone (GH) treatment and parental height. Methods: 201 short SGA children were divided into three groups, SGAL, SGAL+Wand SGAL+W+HC, according to birth length (L), weight (W) and head circumference (HC) ≤-2.00 standard deviation score (SDS). Results: SGAL+W+HCchildren were born after the shortest gestational age and more often by caesarean section than SGALchildren (36.3 vs. 38.1 weeks, 68.4 vs. 24.4%). SGAL+Wchildren had an intermediate pattern and experienced most gestational hypertension (p = 0.01). At birth, SGAL+W+HCchildren were shorter than SGALor SGAL+W(-4.12 vs. -2.67 and -3.72 SDS, p ≤ 0.001). During the first 3 years of life, SGAL+W+HCchildren exhibited an increased growth in height (0.98 SDS) and HC (1.28 SDS) than SGAL(height, -0.06 SDS; HC, -0.30 SDS) and SGAL+W(height, 0.62 SDS; HC, -0.31 SDS). However, HC SDS remained smaller for SGAL+W+HCthan the other groups at age 3. The groups did not differ in growth response during GH treatment. SGALchildren tended to have shorter parents and target height than SGAL+W+HCchildren. Conclusions: Our study shows that subclassification of short SGA children might be a useful method for investigating SGA children as the subgroups revealed a different gestation, delivery and postnatal growth pattern. Response to GH treatment was not different between the groups. Copyright